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ophycare

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icliniq-dataset

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Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my abdomen has been swelling for months and is quite distended something felt like it was moving around in my stomach about eight months ago but i did not pay much attention to it when i awoke yesterday my rectum was itching and my belly button felt as if it had been cut it felt worse after work so i faced the mirror and pulled the skin open around my belly button and a small white worm came out i took pictures of it and have it in a baggie and i contacted my doctors service but have gotten no response i have no medical insurance so i need to cut to the chase and find out who i need to go to for a diagnosis of the type of parasite and treatment ### Response: hello i went through your post and the images you have posted attachment removed to protect patient identity regards for more information consult a general medicine physician online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my daughter has a wbc count of absolute lymphocyte and neutrophil we have been asked to consult a hematologist we are worried as in what type of issue is she having she does not have a fever is acting well and eating well ### Response: but in your child absolute lymphocytosis is present hence your child should be referred to a hematologist for examination especially lymph nodes palpation liver and spleen palpation if needed usg scan can be done for that tuberculosis measles chickenpox hepatitis infectious mononucleosis brucellosis etc are some of the infective causes but specific symptoms regarding that are not present as per history autoimmune disorder and leukemia also are some of the causes these are different causes to provide you information regarding lymphocytosis cause your latest smear report shows high atypical lymphocytes attachment removed to protect patient identity mostly it can be some form of viral infection but we do not want to take the risk and consult to a hematologist for examination and investigate with usg abdomen scan also if needed then flow cytometry like higher investigation can be planned hope this provided information will be beneficial to you while you consult a nearby hematologist for examination take care for more information consult a hematologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a male with a weight of kg and my height is feet inches i have been married for six years i have two children i had yellowish like liquid discharge from my penis a year ago with burning while urinating i consulted a urologist and he prescribed me norflox mg for one week and after which it went away this month i had pain in my scrotum in the right spermatic cord region above the testicle my urologist told me to have sonography my sonography report concluded diffuse thickening at the right spermatic cord region otherwise the report is normalthe doctor prescribed me cefixime mg and an antiinflammatory tablet for days my pain decreased about a week ago i had masturbation and i had pain at the same place in the scrotum i had taken a urine culture test and i have attached the report my question is do i have sexually transmitted diseases or urinary tract infection can i please know what to do what medicines should i take for a permanent cure ### Response: i have gone through your symptoms you seem to be suffering from an infection in your spermatic cord that is the cause of your scrotal pain this is treated with antibiotics but the duration of treatment is usually for two weeks or more the pain you have on masturbation is due to the inflammation of the spermatic cord through which the sperms come out into the urethra i would suggest you keep your scrotum elevated with a tight underwear for pain relief it would also be necessary to make sure that the infection has been cleared by testing both urine and semen for infection as your symptoms are not resolved for more information consult a urologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i want to lose my weight i am very obsessed i want to get slim please tell me some exercises to lose weight please tell me exercises that i can do anywhere without any types of equipment ### Response: hello two very good exercises with which you can lose weight without equipment are as follows running is considered the best exercise for improving cardiac status and losing weight a minutes run each day five days a week skipping is also a good exercise that can be done in a room however restricted calories are as important as the exercise itself to decrease weight

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: no current medicationsfemale age height cm weight lbs last knownwhy do i always have recurring knee painsometimes alternates from left and rightit hurts so much and it keeps coming back even though im not exerting stress on them such as from running ### Response: dear sending love and peace to you my dear there are some condition which causes knee pain i would also suggest to do some test where we can get knee pain on and off these are few condition where there can be like your symptom my dear thank you have a good day

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i had csection three years ago my stomach started bulging so i visited a doctor and had sonography so came to know that i have mild umbilical hernia if i do proper exercise and follow ayurvedic medicine suggested by you then is this mild hernia curable please help me with this also can i climb stairs in mild hernia ### Response: hello i understand your concern since you had csection you are likely to develop incisional hernia which is a common issue faced post csections if proper care is not taken during wound healing it is not curable with only medicines but it can be preventable from reaching further stages if you find and center close by which practices post partum care in ayurveda then get the following done apply dhanvantara taila followed by veshta bandhana abdominal binder avoid lifting weights and too much physical exertion take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: we are trying for a baby for three months i have been facing a couple of issues i feel the symptoms of periods within to days of my previous cycle my regular cycle was between to days before i was taking folvite folic acid tablet but started using iron tablets for two months please let me know what could be the cause or is this normal ### Response: the feeling of symptoms like periods but not actually having bleeding could be due to ovulation pain what is called in medical terms is mittelschmerzs pain if your cycles are ovulatory all the more good try for conception in the middle of your cycle days say in day cycle days do not worry if three months are gone give a fair trial for six months before undergoing any investigations folic acid to continue till you conceive it will prevent neural tube defects in the baby

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am years old i did an cycle that ended days ago the cycle consisted of applying a topical dht gel exactly mg of pure dht per week mg per day for eight weeks i did it because i read that dht could improve my puberty and increase the size of the penis now i am still small and feel that my hormone levels are lower the question is could it be harmful to make another cycle or should i stop now that i have stopped should i do a pct my wish would be to increase the penis dimensions without damaging my hpta axis ### Response: hello i would recommend that you know what you are doing before you try to use it again use of testosterone can cause serious side effects such as heart disease including heart attack stroke liver disease mental and mood problems abnormal

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a female about a week ago i noticed an ingrown hair in my pubic area i left it for a couple of days and then put a hot compression on the area exfoliated and tried to free the hair i used a pin to pull the end out of the skin so i could tweeze the hair out but i ended up popping the pump and pus just started oozing out it was sore the next morning and i let it go until tonight i tried to free the hair again and just ended up squeezing the lump this time it was a bit larger again blood and pus came out but i pulled a hair out with the tweezers and i believe that it was the ingrown hair i just noticed that my right lymph node in my neck and my groin area are swollen i would rather not go to see my doctor any advice and the tweezers and pin were both sterilized both times ### Response: hi after going through your history i suppose you are having folliculitis after take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have a continuous stuffy nose which gives me brief dizzy spells that go once i try to blow my nose not hard it just helps equalize pressure my glucose bp heart tests are normal i eat and drink regularly i work in a dusty environment the dizziness is definitely associated with congestion how can i stop it ### Response: either a dust allergy or infection is causing you an allergic rhinitis you will need xray pns waters view and ct pns for a confirmation i suggest taking avoid dust by covering with a facemask follow up with the reports for more information consult an ent otolaryngologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: as of now i am suffering pain in my left rib which results in difficulty in breathing i suspect this happens when i fall asleep on the sofa in an awkward position and when i woke up my throat has a little pain but it did not persist but but it started to ache on the left rib part i feel the pain towards my shoulder it is almost about two days since i am suffering from this achei got breathing difficulty especially when i am lying in bed but while standing or sitting i just felt mild difficulty in breathing maybe there is an artery that has been damaged or had been under the bone i am years old ### Response: hi i can understand your concern according to your statement you have been suffering from difficulty in breathing due to aching of the left rib part that radiates toward shoulder which may occur when you fall asleep on sofa in an awkward position you think your ribs may hurt from sleeping wrong and aching of the rib may radiate towards its intercostal muscle you may feel a sharp pain after intercostal muscle strain or sprain due to sleeping in the wrong position the pain will become worse when you stretch breathe in deeply cough or sneeze the area of the strain between your ribs may be painful to touch again this pain can radiate to shoulders or sometimes side sleeping can cause damage to the rotator cuff and create a lot of pressure in this group of tendons and eventually produce pain you can take tramadol as a painkiller domperidone lansoprazole and diazepam as a muscle relaxant with a sleeping pill

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my mother is years old all her general physical parameters are normal and she is leading a normal healthy life but she suffers from migraine so whenever she has migraine headache she takes analgin novalgin medicinefew days back she took the analgin and noticed swelling in her left forearm photo attached this swelling has occurred in past too but this time it persists for a week along with general body pain fatigue and mild sweating at times bp and temperature are normal family doctor suggested full body check up chest xray few blood tests and thyroid test specifically all came normal except thyroid report attachedshe did not take any medicine for the swelling yet please suggest what could be the cause how can we prevent it ### Response: from the reports attachment removed to protect patient identity her tsh levels are high with normal and which suggests hypothyroidism most of the times hypothyroidism has normal and so hypothyroidism can not be ruled in that case her complaints like sweating and everything fits under hypothyroidism i would like to know whether she had any recent injury including minor trauma revert back to a general medicine physician online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i seem to be getting these dizzy rush sensations they happen randomly throughout the day but mostly when i am on the computer it feels like an electrical pulse is surging up through the back of my head i also feel dizzy turning side to side and when i get a headache it feels like it is coming from deep within my left ear it causes me to panic and get a lot of anxiety afterward what could this electrical rush sensation be then also after i get it i can not look up too quickly because i feel very dizzy it usually happens again while typing on the computer or looking down at a smartphone ### Response: hello i will try my level best to help you out your symptoms are mostly dizziness which worsens with sudden eye movements or body movements and are sometimes associated with headaches based on the symptoms the most common cause in your age group is a vestibular migraine or benign paroxysmal positional vertigo bppv i assume you do not have any other risk factors such as diabetes hypertension previous stroke or diagnosis of epilepsy a simple neurological exam using dix hallpike maneuver can help differentiate between bppv and vestibular migraine also further questions on the quality of headache location and associated symptoms such as light sensitivity loud noise sensitivity and nausea are other important questions that can happen with vestibular migraine treatment for bppv is physiotherapy with some specific exercises and medicines such as topiramate or valproic acid for vestibular migraine if there are any red flags on neurological exam then an mri magnetic resonance imaging of the brain would be needed please do not hesitate to ask me any other questions take care for more information consult a neurologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am having irregular periods shall i take kalarchikai choornam ### Response: there are several causes for irregular menstruation pcod is one of them if you do have this issue then you can take kalarchikai choornam gm twice a day with warm water after meals for three months regularly to rule out this issue once you should go for usg abdomen pcod hypothyroidism taking contraceptive or emergency pills inflammatory pelvic diseases climatic changes food changes etc usg abdomen thyroid profile if you have an irregular period due to pcod then you can go through kalarchikai choornam as the abovementioned dose

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: can a ct scan identify liver metastasis ### Response: hello yes ct computed tomography scan can detect suspected primary tumor or metastasis in the liver however it is not confirmatory a biopsy is needed to say its malignant origin if the primary tumor is not already found in other organs

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have a problem my teeth are brittle because if i eat something hard they sometimes break or i would feel a hole developing and this is stressing me out because i have already taken out three of them and now another one is close to being totaled earlier today i ate something and i think it damaged them i am tired of taking them out ### Response: there must be one of a few reasons for this chipping off of teeth rapidly you might have calcium and vitamin d deficiency to rule out this you can get serum vitamin d laboratory test done if there is deficiency then i recommend you medicines for it another reason might be the hereditary cause that means even when you maintain your oral hygiene brush properly eat less sugary stuff and chocolates still teeth are breaking off suggests it is because of genes you have got from your parents or grandparents they would be more prone to damage and their teeth would be weak as well in this case you can not do anything but visit a dentist properly and get all services done beforehand to avoid further damage can you provide me with a clinical picture of teeth so i may suggest accurately what should be your line of treatment stay happy and blessed take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my wife is suffering from peripartum cardiomyopathy for the past six months she is taking beta blockers and diuretic medicine for the past four months her heart ef is with flat t in ecg reports her heart function is normal how many days does it take to get cured ### Response: hi peripartum cardiomyopathy is a condition with an unknown cause it follows after delivery for a few days to few weeks and manifests with the symptoms of heart failure beta blockers and diuretics are suitable but the condition is not completely curable the symptoms can reduce with the medications please send the ecg electrocardiography and echocardiography report to review it some cases can also show electrolyte imbalance like hypocalcemia or hypomagnesemia due to diuretics it can also affect the ecg take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my age is i have undergone a surgery for bladder augmentation nine years back since then i am doing bicarbonate wash every week please suggest an alternative for this procedure ### Response: the point of bicarbonate washing off bladder is to create alkaline nature which is not a good environment for harmful cell to grow thereby inhibiting cell growth and it will strengthen the bladder yes what you can do is limit sugar meat dairy products etc which make our body more acidic there is no substitute for the method bicarbonate washing is the best method i will advice you to continue it i understand it may be tiring but the method itself is effective also ask your doctor how may total bladder wash you will be needing as i know this procedure is not for lifetime

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: what is your recommendation for someone with ptsd depression and anxiety ### Response: if a person is suffering from ptsd posttraumatic stress disorder depression and anxiety they will probably need a combination of medication and psychological therapy to manage their condition lexapro escitalopram is a good antidepressant that can be helpful in this situation based on more clinical information and formulation psychological therapy can be considered if ptsd is the predominant primary condition traumafocused cbt or em

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a boy i am very thin i want to gain weight in short span of time is there any ayurvedic medicine for this ### Response: hello you can achieve your goals easily through ayurvedic medicines and yoga practices ayurvedic medicines and yoga are able to correct your metabolism and help to improve your concern treatment plan includes

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my wife is weeks pregnant with my second child her level one scan is normal and the double marker is also fine but the doctor has told to get dna test that is an nipt test is it important if level and the double marker are fine then dna and nipt test should also be fine right ### Response: double marker level scan and nipt noninvasive prenatal testing all are screening test and not diagnostic they just suggest a possibility of the disease so if both the testsare normal you can avoid taking nipt test it is not a compulsory test and again a screening test but it is very costly and this test also does not identify all chromosomal disorders as others these two tests are always recommended at this age if there is a family history of chromosomal disorders or previous pregnancy with any disease then only one should opt for nipt for more information consult an obstetrician and gynaecologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i was suffering from minor achilles tendinopathy and visited a physiotherapist today to get it checked during the session he performed some deep tissue massage on the calf which was very tight to relax it which was very painful after the massage i experienced sharp pains while walking which was not there beforehand and when i brought this up with the physio he said it was normal because it was the first time i had gotten deep tissue massage on that areai have been icing the calf and resting and while it has gotten a little better it still hurts to walk i have my exams tomorrow which i have to get to and other events on the weekend where i have to be and will involve walking i am worried about how i can see as i can not walk at all is it normal to experience such pain after deep tissue massage to tight calf muscles or did i sustain some injury say a muscle strain or something similar and need to get it checked out ### Response: i read your concern sometimes usually they try to break the trigger points and it would have caused discomfort the technique itself is proinflammatory techniques and will induce some more inflammation so that healing happens so do not worry now i request you to ice your calf frequently like once in two hours for minutes as of now and stretch it properly things should settle down fast tomorrow morning you might feel a lot of stiffness in the calf do not worry as you have to stretch your calf gently and roll your calf over a foam roller or if have somebody ask them to massage it for few seconds things will be fine you can walk without pain i hope this is helpful to you kindly revert in case you need any further information in this regard

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: approximately one week ago i had my wisdom teeth removed on my lower left i have a dry socket which i am getting treated for via packing at least i think that is what it is called on the right side healing is just fine however i noticed some white stuff lodged in the gum i am not sure if it is food or scar tissue because when i tried to get it out with a toothpick it did not come out very easily so i left it alone is this food or scar tissue it is mildly bothersomei brush my teeth but know to be careful around the surgical sites so they do not get irritated it seems like a lot of plaque builds up back there because of this and i am not quite sure what to do also there is a very small spot of red gums on the front side of my second molar i put a bit of mouthwash on it with a toothpick and left it alonei have two questions what is the whitish stuff that feels like food trapped in my healing gum socket and what is this small patch of irritated gum on my second molar any help is appreciatedi am currently on celexa for depression mg of ibuprofen for wisdom tooth pain ### Response: hi as it is just one week of wisdom teeth extraction the white stuff seems to be most probably healing tissue only it is a normal appearance of healing tissue postextraction a white patch of irritated gum can be due to injury or ulceration that can be due to accidental injury with the extraction instrument or can be due to injury with a toothbrush or any hard food you can apply chlorhexidine gel over it do warm saline gargles antiseptic mouthwash gargles and brush your teeth twice a day for keeping plaque and deposits less accumulated i hope this helps

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am years old i have a problem of hair fall my hairs fall so quickly and there is no regrowth of hairs please help ### Response: nowadays hair fall is very common due to change in lifestyle and food habits excessive use of different kinds of shampoos conditioners and washing hairs using hard water result in hair fall reduced blood supply to the hair roots makes the hair weak and it leads to hair fall you should follow some precautions to prevent hair fall apply bhringaraja oil to the hair at night massage the hair for five to ten minutes and wash them with water the next morning shampoo your hair weekly twice or thrice using protein shampoo do these things and provide your valuable feedback

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i had a tooth extraction a week back and three days later the clot came out of the tooth now i am not in any pain i get the occasional tingle or slight pain but i am terrified of getting dry socket i am rinsing with salt water every half an hour or so should i be worried about it developing ### Response: hello as your attachment photo reveals there are little chances of getting take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have psoriasis for a long time for which i have been taking methotrexate last week i got my iron studies and blood test done my transferrin saturation and total iron levels are low but hemoglobin is fine kindly advice ### Response: hello your transferrin saturation and iron level are mildly decreased and your hemoglobin level is normal so you do not have iron deficiency anemia but it can be an early sign of iron deficiency you need to investigate with serum ferritin level because that indicates iron storage level you need to take ironrich foods like red meat beans pumpkin seeds and green leafy vegetables etc there is no need for taking an iron tablet as hemoglobin level is within the limit i hope this will help you let me know if i can assist you further take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a male i have swelling and discomfort in the testicle and sperm canal i have wandering aches and pain around the groin area including buttocks and inner thigh i am having these symptoms for the past four to five months i am not taking medications i have tried neurontin with a low dose of mg taken twice daily for two weeks but i stopped it because of its side effects and it does not relieve my symptoms i had shaking episodes of anxiety and worried that i might have contracted herpes i have tested for all the common stds which showed a negative result except herpes simplex showing a positive outcomei am also experiencing impotence i had undergone a hernia operation with a net before years also i had undergone a small hernia surgery on my right side which is not very visible i do a lot of swimming about kilometers per week i have overstrained myself i had a sexual encounter with someone whom i do not know a lot i have wandering pain around my lower abdomen and groin often it is hard to distinguish where the pain gets originated sometimes it involves both upper and inner thigh in the vicinity of the testes sack i have tenderness and minor swelling in my testis and epididymis i have difficulty in erection ### Response: hi i understand all your concerns i have checked the provided information thoroughly i need to know more details do you have any redness swelling or ulcers in the genital or groin area have you performed urinalysis please send me some photos if possible

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i just recently started urinating blood when i go to the restroom i have a constant urge to urine and i have no idea why out of the blue this is happening i am a male years old lbs i have no medical issues or past history of kidney problems or cancer can it be due to std ### Response: hi painless hematuria must be evaluated thoroughly and some factors must be taken into consideration like smoking occupational exposure to certain substances family history of kidney disease or cancer do not get scared sometimes it is something simple like urinary tract infection or mild trauma in the urinary tract or mild stone please get the following investigations done so that proper treatment can be initiated infection trauma urine routine and microscopic examination abdominal ultrasound abdominal ct scan take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my foreskin of the penis is tight is there any problem in the future during sex my age is years male and single ### Response: if the foreskin has become inflexible rigid and inelastic it may cause pain while having sex it usually occurs due to a condition known as phimosis the main cause being poor genital hygiene visit a urologist or a general surgeon to assess whether it will need partial or full circumcision or can be retracted fully without any surgical intervention

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have minor beta thalassemia which i got from my mother but unlike her asymptomatic i have anemia symptoms like paleness shortness of breath after the least effort feeling tired all the time broken nails and i want to know if it could be due to lack of iron could people with minor beta thalassemia also get iron deficiency anemia knowing that i get heavy cycles and my diet is very poor ### Response: hi i have reviewed your query and here is my advise yes your symptoms point towards iron deficiency anemia in beta thalassemia minor patient usually feels more fatigue on exertion as compared to normal people without thalassemia however do not worry regarding thalassemia minor they can live a normal life thalassemia people can develop iron deficiency anemia secondarily so rule it out by cbc profile with blood indices as well you can revert back with reports so that i can guide you further

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: me and my fiance had sex and seems out of fear took ipill because it was unprotected for sometime so many doubts in mind but no leakage or injection of sperm etc three time upt done but all negative after taking ipill period comes as per regular cycle for days but next period only one two hours bleeding and then stopped this month period is skipped till date say it late by day including today do i need to visit doctor or wait ### Response: if you had taken ipill within hours of unprotected sex it works well as emergency contraception about since you had a regular periods after taking ipill pregnancy is unlikely ipill is hormonal pill containing synthetic levonorgestrel which can can sometimes disrupt normal menstrual cycle it is possible that your regular menstrual cycle has been affected by taking ipill but the side effects are transient and usually menstrual fluctuations disappears by the following cycle since you are reporting persistent delay in having your periods it is advisable to consult an og doctor to have a check up and help to reestablish normal periods again it will be reassuring to you as well do not worry there will be no long term side effects due to ipill but it should not be taken often

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am of and i am suffering from permanent blurry eye vision in my only right one it is by birth is there any chance to cure it without any permanent glasses and without any operations suggest me please ### Response: hello i understand that you are having blurred vision in your right eye since birth this kind of presentation can be due to a variety of reasons the most important being amblyopia this is a weakness in your vision nerve and the vision centers of your brain this diagnosis can be made after the examination of your eye and vision in case you suffer only from a problem which is cured by wearing glasses you have the option of getting the surgery done in case you have amblyopia or other neurological problems they are not corrected by glasses or surgery that needs attention my suggestion is to get your eye test done and read through the job requirements of the jobs you are applying for in case you are having any trouble understanding or need some help with technical details please send a scanned copy of your doctors report and your job requirements i will do my best to help you

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i saw these lesions on my scrotum and outer genitals yesterday i am currently on day of chicken pox what could these lesions possibly be from is this an std ### Response: your concern is folliculitis start metronidazole gel in the morning and tbact mupirocin ointment in the evening on the affected areas if they resolved ignore but if they flare then have a physical examination by a dermatologist nearby you it is not std

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my last period started a month back the next week i was on a z pack for a throat infection i have not gotten my period this month i am to days late took six different brands etc pregnancy tests are all negative what could be causing this late period i am under a lot of stress also ### Response: the fact that urine pregnancy test is negative and as this is the first time that your menses have been delayed and there is a likely cause present the throat infection and the stress factor during this month so stress as we know that it can easily cause hormonal imbalances which can delay menses you are likely experiencing a stress delay

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a female i have been on depoprovera for six years i am not taking any other medications lately i have been experiencing severe mood swings and have not been myself one minute i am dancing around the room and could not be happier the next i am either crying or very angry normally i do not cry and i am usually pretty laid back i have also been getting dizzy mostly when i stand up or walk up the stairs i have trouble sleeping and or sleeping too much i am hungry all the time however when i do eat i feel nausea i have done some research and have found that these symptoms are both common with the injection and also with pregnancy how do i tell if these are pregnancy symptoms or if it is because of the depo shot i did miss my last shot three months ago last month i took a home pregnancy test it came back negative will a home test be enough to tell if i am pregnant or not ### Response: hi the home pregnancy test is fairly sensitive and very unlikely to miss pregnancy except in very early pregnancy if you suspect pregnancy strongly you can repeat a home pregnancy test again after a week if period does not start most of your symptoms can be either due to indigestion or hormonal imbalance hypothyroidism or estrogen deficiency you can take antacids pantoprazole for three to four days and see if symptoms resolve if your symptoms do not resolve and pregnancy test comes negative you can do tsh thyroidstimulating hormone test to rule out hypothyroidism as you have taken depot for a long time estrogen deficiency is likely which can cause all of your symptoms if possible shift to oral pills for contraception for a few months to avoid the same i hope this helps

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i had stomach pain after which my report was confirmed as gallbladder stones what is the further procedure please let me know all the details including the cost ### Response: the mere presence of gall stones does not mean that your abdominal pain was from the gall bladder many people have gall bladder stones which do not give them any symptoms when the gall bladder gets inflamed or when a gall bladder stones block the bile duct you get symptoms like pain fever and jaundice so we need to ascertain whether the gall bladder stone was responsible for your abdominal pain or not if it appears that the stone was the cause of your pain then surgery can be considered laparoscopic surgery keyhole operation can be done and many hospitals have doctors trained in this the cost of the procedure varies from hospital to hospital you should however first make sure that the abdominal pain was directly related to the gall bladder stone please upload the copy of the scan report and also indicate in which part of the abdomen you had pain the gall bladder is located under the right rib cage margin i hope this helps

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my days newborn son is suffering from midgut malrotation is this a problem ### Response: hi abnormal relationship of the vessels can cause intestinal obstruction or volvulus it may be asymptomatic as well if it is symptomatic in the form of pain that is related to malrotation then this baby may need corrective surgery you should show to a pediatric surgeon

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: obstructive jaundice has been detected ercp was done serum bilirubin still very high mrcp report says everything is alright but neither serum bilirubin nor yellowness has got less ### Response: hi i have gone through your case and can well understand your genuine health concerns in obstructive jaundice there is an accumulation of conjugated bilirubin in the body due to obstruction at different levels in the hepatobiliary system which causes yellowish discoloration ercp helps in clearing the biliary system sometimes only the biliary sludge will be found in ercp bilirubin takes some time to get completely cleared from the body repeat your liver function test after a week if it is still high other causes should be ruled out you can try ursodeoxycholic acid udca which comes with the name tablet udiliv mg once daily for two weeks as it helps in clearing bilirubin take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am years old from the past two weeks there is a slight pain in my right ear i tried clear wax ear drops and normal ear drops then there is a relief for a certain period then again mild pain is coming the next day when i wake up in the morning there is a very slight headache kind on the right side and some sort of discomfort in my right ear there is not severe pain but certainly there is some sort of mild pain i also noticed whenever i tried using earbuds in my left ear to clean then i am getting cough as if some sort of itchiness sensation in the ear is causing immediate cough in the throat and normal again after i take earbud out i want to know whether i should consult ent specialist immediately or if there are any ear drops in particular to use before i go to ent doctor ### Response: the cough which occurs during ear cleaning is due to stimulus to your auricular branch of the vagus nerve which is normal now coming to your problem many times mild pain occurs due to impacted wax or etd eustachian tube dysfunction both cases it is advisable to consult an ent surgeon for the proper examination of the ear never try to clean the ear yourself as it can cause injury to your ear

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i had a month old twin baby girls they were born in the week of pregnancy one baby was kg and the other was a little weaker weighing kg since there is not enough mothers milk after several attempts i had to go for artificial milk powder initially as suggested by the hospital pediatrician they were given dexolac special care but after day when their weight was around kg they were given to dexolac premium out of the babies the weaker baby is responding well and quickly gaining weight taking around ml milk every hours but the baby which was born stronger is not drinking sufficient milk ml in one feed at an interval of around hours and is taking around an hour to take one feed also she is having issues of gas and constipation because of constipation she keeps crying now this baby is not gaining weight and seem to be weaker please suggest what we can do in this case and shall we switch her milk to lactogen or some other company ### Response: hello keep trying to give breastfeeds as much as possible till months completion different brands of milk powder have different tastes so you can change what they like as advised do not dilute more or give more concentrated milk usually dilution mentioned on the package can be followed that is ml for scoop for most of the brands but check with the manufractures note do not use feeding bottle use bowl and spoonyou can use undiluted dairy milk pasteurized check with your local pediatrician for supplements if needed check if there is adequate weight gain maintain proper hygiene while feeding when using formula feed or top milk do not compromise on hygiene i would like to know the following finally breastfeeding is the best for the babies

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am years old i am married i have a bit problem in my sexual life whenever i insert my penis in her vagina she told me that when i insert full penis in her she feels pain is it normal or not ### Response: painful penetration in women may be caused by any injury or lacerations in vaginal walls infection of the genital tract forceful or violent sex lack of lubrication in the vagina i think you should do a lot of foreplay before penetration so that her vagina may get lubricated naturally also it is highly recommended to use a waterbased lubricant like ky jelly always be gentle to your partner while having sex that is the key

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am weeks pregnant and i want to terminate it please suggest me some natural methods ### Response: yes there are medical methods available which could be availed under a doctors supervision only this is an abortion kit containing one mifegest mifepristone tablet mg to be taken orally and misoprostol mcg to be inserted per vagina after hours of taking the mifegest you may have a bleeding per vagina just like your cycle this is a prescription medicine as well as there are some chances of more bleeding per vagina which you have to keep it in your mind just get in touch with your doctor if there are rare chances of excessive bleeding as you may need a surgical evacuation at that time this method is applicable up to weeks only and if you have to adopt it do not delay further ultrasonography usg after days

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i went for an annual health checkup and found there was a minor change in the ecg i am years old my weight is kg and height is cm my bmi is and waist circumference is my bp mmhg i am also attaching my ecg report to you i need your suggestion thank you ### Response: hi you may go for electrolyte levels in the blood and renal function tests to be on safer side though no need if you do not have a history of renal disease or medicines that may cause increased potassium levels

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my baby is months old i have given vaccine to her on of this month since then she was having fever every four hours the other day too after that she is not drinking breastmilk and formula too now only drinks at night time while sleeping what should i do ### Response: i understand your concern usually vaccines are not related to decreased feeding fever might be because of vaccine only but not decreased feeding it may be a sign of infection is the baby dull or lethargic is there any recent formula change what about stools and urine is it normal or less is the child irritable or is there any swelling at the vaccine site you should definitely see a pediatrician if this persists

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a year old female and a diabetic for the last ten years i had a cystocele repair surgery along with hysterectomy and cervix and ovaries removal five months ago there is a slight discharge on and off i did a urine culture now and found that there was a colony of enterococcus faecalis please let me know if this is serious and whether i have to take a course of antibiotics for it i do not have any symptoms of uti or abscess etc also the cystocele repair was not a success as the bladder is still at the mouth of the vagina please also let me know if anything can be done to put the bladder back in place if this is not done what are the repercussions ### Response: i have gone through your query and understand the concerns hope you found the answer helpful regards for more information consult an obstetrician and gynaecologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have been with the same partner for years now during these all years i have had several utis with some leading to severe kidney infections last week after almost two years of not having a uti i felt the horrible symptoms again when going to the doctors uti urine test came back positive the doctor prescribed me seven days nitrofurantoin antibiotics which cleared the pain and seemed gone entirely unfortunately two days later the symptoms came back please note that i had sex with my partner the day before with burning sensation when urinating and painful when standing with the need to go toilet every to minutes i went back to the clinic the same day to get it checked and take more antibioticsbut to my surprise the urine test came back clear for uti and my symptoms disappeared then the doctor advised me to get tested for chlamydia as the symptoms can sometimes be mistaken to be uti i have been diagnosed with chlamydia at the beginning of this same relationship and was treated for it my partner was also tested but his results came back negative is it possible that the treatment that i had for chlamydia years ago did not clear it entirely and this lead to several utis and kidney infections and also would the antibiotics for uti clear chlamydia thank you in advance for your help ### Response: in uti initially a broadspectrum empirical antibiotic given and then according to urine culture report a specific antibiotic prescribed a certain antibiotic like azithromycin if prescribed for uti will be effective against chlamydia as well if chlamydia infection present recently then some irritation itching discharge like complaint present and swab culture can be done for that if needed frequent intercourse pelvic hygiene if not maintained stone in the urinary tract diabetes mellitus etc are some causative factor for recurrent uti maintain pelvic cleanliness especially after intercourse wash and clean the pelvic area immediately after intercourse consume fruit juice like cranberry juice more wear loose undergarments rather than tight underwear take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am years old and have been diagnosed with multiple uterine fibroids two of them are a little more than cm at different places in the uterus in the past i have been operated for endometriosis level as usual the gynecologist is suggesting a hysterectomy but since i am in my perimenopausal phase can the fibroids shrink with medication i have been suggested fibroease ### Response: hello the medicine you are taking is good for your condition if you want to try shrinking it with medicine alone you can continue that along with that i advise you to visit a nearby ayurveda physician or a panchakarma center and ask for the procedure related to fibroids usually virechana which is a purgation therapy which is done and also medicine is given it helps some patients in getting relief take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my daughter is months of age she was born at weeks due to placenta failure and oxygen issues she was lbs ounces at birth and was healthy did not have to stay in the nicu she hit all of her milestones in terms of rolling over crawling and walking walked at months but is a toe walker her left leg to us is weaker than her right and her left leg does not bend as much as her right leg she began to speak around months of age then her speech left we came to find out she had chronic fluid and a month back she had tubes placed i am hearing more vowel and consonants now but no true words yet she makes fine eye contact her nonverbal communication is good she responds to her name but not always she is beginning to learn more of what we are saying she plays with some toys is not terribly social we are thinking that she may be on the autism spectrum and we have an evaluation soon to determine that but my question is could this be cerebral palsy ### Response: i understand the situation you are facing with your child as there is no history of perinatal insult and nicu stay at birth cerebral palsy could be less likely at this early age to diagnose the description you made is more of a like to be an autistic spectrum disorder but this could be just a small delay in catching up all milestones some kids learn early and some little late so observe over a period and if no improvement is seen then consult a pediatric neurologist and developmental specialist for further evaluation and management

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i sat on my testicle before two months and i experienced an initial sharp pain for a few hours i went to the er and did a blood test urine test and an ultrasound torsion as well as infection was ruled outthe exact incident occurred before few days i did a urine test and another ultrasound torsion was ruled out once again when the pain flared up again i went to the doctor back again i did an ultrasound urine test and blood test torsion and infection were ruled once againthe doctor pointed out a little bit of fluid around my testicle and i had no pain but still i have pain in my testicle what was ruled out with these tests from where does the pain arises ### Response: hi i have gone through the attachment attachment removed to protect patient identity this acute testicular pain with normal testis examination and ultrasound report look like simple orchialgia ruling out torsion is very important in young males presenting with testis pain it shows that the testis is not twisted on its own pathologic pain has associated redness and swelling from your report i can say that you do not have torsion and epididymitis young males have simple orchialgia due to muscle tone you need scrotal support take tablet pregabalin mg at bedtime

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i got an accident before a month i got a right knee acl ligament type tear is it possible for the type ligament to get cured by itself without operation and if so how many days does it take to heal ### Response: acl anterior cruciate ligament tears will not heal on its own as they are inside the joint to bring the ends together you need surgery but even that too is not successful it is the reason for doing acl reconstruction it is not recommended for everyone only if your knee is giving way or if it is unstable or when you are unable to lead an athletic life then you need an acl reconstruction

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a year old female i have a minor issue about a month and a half ago there was an incident where the condom broke about hours later my husband got me four of the morningafter pills and i took them all at once three days later i started experiencing nausea soreness of the breasts lower back as well as abdominal pain frequent urination and tiredness this carried on for almost a week i then noticed a light brown discharge and from the next day i bled for six days i usually bleed for seven days after my periods i still had the symptomsnearly a month later i got my periods again but on the first day i had severe cramps and used a tampon on the third day there was a slight discharge which was brown in color on the fourth day there was some bleeding but not at night today would be day five and i still do not see blood my main concern is that my vagina feels different it is more firm than usual and feels tight i sometimes feel a pulling sensation could it be due to the morningafter pills i did home pregnancy tests and it came back negative it has been a month and days now since the intercourse ### Response: hello please let me know if you were previously pregnant since you took the emergency contraception pill within hours and you got your period after the intercourse you are not pregnant the emergency contraception pills are progesterone tablets it is a hormone normally present in the body which is secreted in the second half of your menstrual cycle it gradually decreases in concentration due to which you get your menses when you take progesterone orally in a higher dose to prevent pregnancy some females experience the side effects of the tablets although your menses were on time some patients may experience irregular menses for two to three months hope this helps for more information consult an obstetrician and gynaecologist online take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a female i was just diagnosed with chronic urticaria i went to an allergic specialist for skin testing because my skin was so sensitive i reacted to everything they then did the rast test on me everything came out class except for egg white wheat and oats being class and milk and hazelnut being class can these cause anaphylaxis how accurate are the rast test i was put on an elimination diet but the hives are still there i occasionally get angioedema with it also can angiodema cause anaphylaxis as you can see i am so scared for my throat to close up that i am scared to eat anything i have only been eating a couple of things daily and live off that ### Response: rast is a highly accurate test if the test is positive for a specific allergen it shows that you are sensitized to that particular allergen this means that you may mount an allergic response when you are exposed to that allergen however it does not mean that you will necessarily have an allergic reaction to that substance and nor does it mean that any reactions will be severe if the test is negative it means that one does not have the ability to mount an allergic reaction to that allergen and any symptoms one may be experiencing are probably not due to an allergic reaction to that substance however the results of the rast need to be interpreted in conjunction with your clinical history eg the presence of allergy to some or few allergens which may possibly be present either in the environment or food does not necessarily mean that they are responsible for the symptoms because if they are not even present in the environment or food of an individual then they are irrelevant in your case an elimination diet has not helped thus proving the fact that rast test results should be carefully interpreted along with clinical history and does not necessarily mean that you will necessarily have an allergic reaction to the substance that you tested angioedema is frequently associated with urticaria pathogenesis is the same for both urticaria as well as angioedema the presence of angioedema does not always mean that it is a part of anaphylaxis angioedema can be a part of anaphylaxis in those individuals who have a severe allergic reaction to an allergen with high levels of antibodies circulating in the blood since you have only class and level antibodies therefore it is unlike that these antigens or allergens would cause anaphylaxis

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: since the last months my periods are very irregular i get periods only once every three to four months i am on treatment for abdominal tb since the last one and a half years i take sompraz on an empty stomach in the morning i take duonase nasal spray two puffs in each nostril twice a day i take immunace forte after lunch and libotryp at bedtime so why are my periods not regular is this a side effect of my medicine or could it be due to a disease recently i was also prescribed once a month for six months my recent vitamin d total is ngml i also have sudden weight gain my weight in the last one and a half years increased from kg to kg i also have a chronic nose block ### Response: hello your irregular periods can be due to your obesity you need to lose some weight you have a history of tb tuberculosis so there may be chances that your uterus might have got affected due to that i suggest the following tests for more information consult an obstetrician and gynaecologist online take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i had a history of thyroid issue before pregnancy currently i have an issue of hair fall and mild body aches ### Response: the likely cause for hair loss is low hemoglobin and also for body aches is low hemoglobin and low vitamin d your esr erythrocyte sedimentation rate is elevated which is due to low hemoglobin attachment removed to protect patient identity your thyroid is fine so you should have iron supplements like tablet fericip xt iron and folic acid twice a day after breakfast and after dinner this may cause some gastritis also you should have tablet uprise units once a week for eight weeks followed by once a month for next six months for more information consult an internal medicine physician online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have a generic query can we trust the nabl and cap accreditation laboratories in terms of reliability and accuracy and what does they mean and all nabl and cap labs are of same quality please explain in detail ### Response: hello it is good that you are noticing such accreditation nabl accreditation laboratory definitely has good quality work and is more reliable nabl is not compulsory to all laboratory but its accreditation ensures that the laboratry is following standards set by nabl board to provide good reports to the patient so yes you can rely on nabl accrediated laboratory take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: how eating habits or certain foods impact sleep how much should men be stretching at does the need to be flexible vary by age ### Response: eating late heavy dinners will certainly affect sleep and also missing the meal altogether should avoid fatty meal especially at dinner time meals taken with lots of fluids are to be avoided too men should try and remain as flexible as possible really more stiff you are more likelihood of osteoarthritis setting in more likelihood of injuries aim to continue with stretches for as long as possible

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my baby is months old and he is two months premature if i feed him with solid food he does vomiting is it not safe for him to feed with solid food ### Response: hello i just read your query i advise you to try giving some soft and semisolid foods to your baby right now once he starts digesting these then move on slowly towards other food items moreover some babies do not take solid food properly until they develop teeth but if your baby does not digest semisolid foods too then you need to visit a nearby child specialist because it can be due to some other underlying cause which needs to be ruled out i hope you understand my point

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am kg i had unprotected sex a day before i got my period on the day of cycle it lasted for four days normal today is the day from when my period started and i am getting bad backache my breasts hurt usually happens just before period and sticky egg white discharge am i pregnant or is it ovulation i had taken a pregnancy test before i got my period because i was late and it was negative i have mild pcos so my periods are never on time but happens every month is it possible to be pregnant after you get your period ### Response: i have gone through your history and understand your concern this is very unlikely to be pregnancy as a proper period followed and when upt urine pregnancy test was negative just before the period so you are at present not pregnant and no chances of pregnancy even with that last unprotected intercourse the nature of discharge is suggestive of ovulation only however if still any doubt in your mind you may take two pregnancy tests one immediately now and another after a week if both are negative you are not pregnant for more information consult an obstetrician and gynaecologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: nowadays i am getting a migraine for every three days alternatively before few days i usually get a migraine once in days often i have a visual problem and aura symptoms it relieves after taking zerodol please suggest ### Response: hi a migraine has two types of treatment when the duration of the attack is more than hours we need to use both abortive and prophylactic medicine in your case you must use both the treatments make a daily diary to sort out the triggering factors such as lack of sleep fatigue stress certain foods and vasodilators avoid it soon take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am suffering from epididymitis problem sometimes i am having pain in testis while having a gastric issue as well kindly help me to get rid of this ### Response: testicular pain with these doppler findings attachment removed to protect patient identity shows some infection of the epididymis if it is a recent onset symptom i suggest have you been prescribed any medicine for this ailment any associated urinary symptoms how is the flow of urine please attach the urine analysis report relief of pain will take some time and swelling may take three weeks to subside

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am years old and had an herinated disc and had surgery a few years back it was a post delayed surgery due to the delay in surgery days i left with a foot drop and right leg weakness i was bedridden for months totally weak but i gradually developed doing physiotheraphy and with some ayurvedic treatment i started waking now with out any help but my foot drop is still there but i can lift my toe and ankle little bit from last month can i come to my normal life how long i need to wait to get cured from foot drop ### Response: hello i can advise you in detail if i have your detailed neurological charting including assessment of motor power sensory charting of lower limbs and evaluation of deep tendon reflexes also latest mri of ls spine is required to see for adequacy of decompression to answer your query the best results come early after the spinal decompression surgery if motor loss can be ascribed to compression in spinal cord or roots also intensive physical therapy helps you to gain power but since you have started gaining power it can continue for at least more months so my advise to you will be to continue with intensive physical therapy including muscle stimulation vitamin intake and come back to me with your neurological charting and mri films so that i can see and advise you further

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i was at the dentist yesterday and had a gum cleaning and now today there are bumps in the back of my mouth on top and my gums right there also look red and there more looking like balls per say ### Response: i have been through your query and i can understand your concern the feeling of strange weird and sometimes loose tooth are major complaints that a patient generally comes with after having the cleaning scaling and root planing done this is because of the removal of the debris earlier what would have become normal for the patient is now removed debris and the patient interprets it somewhat as loose tooth and strange feeling the redness you are referring to is the erythmatous tissue that generally occurs post cleaning because the gums while cleaning gets separated from the tooth structure like an injury however the healing capacity of gums is very fast and it would be go in days referring to the picture attachment removed to protect patient identity the bumps you are saying you do not need to worry about as also you are saying that there is no pain means they are not infected they might have occured due to the injury of hard palate during cleaning i would suggest you to not worry as they are generally seen after cleaning is done they would be gone after some days generally days however if the bumps persists beyond one week i would advise you to have a visit to your nearest dentist for proper and overall examination moreover i would suggest you to keep maintaining good oral hygiene by brushing twice daily and floss regularly also rinse your mouth with oral rinses for days a week and weeks a month i hope i have satisfied you with my answer

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have a milky like white color on my tongue that is more noticeable in the back my tongue should i be worried i am a nondrinker and smoker ### Response: hello the condition that you mentioned can arise due to a variety of causes you have not suggested whether it is associated with pain burning sensation or itching let me name a few conditions where the milky white appearance on the tongue is generally seen candidiasis associated is with pain and burning sensation at times can be scraped off the tongue usually occurs in diabetics leukoplakia is nonscrappable painless but can progress to cancerous condition if not treated early oral lichen planus is associated with a burning sensation pain may or may not be present people with a poor immune system are usually prone these are the conditions but be relaxed it is completely curable make sure you see your doctor as early as possible and have the condition diagnosed early intervention and prompt treatment is the best solution take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am years old i am married from the last years my problem is that from the last two weeks i am am not getting proper erection during sex erection comes a bit and goes out instantly it is just happeing from the last two weeks before that i was totally fine i am taking some herbal medicines please suggest me why this happening to me right now i cat get any erection sex only a bit if i watch some porn or like that i am having so much tension because of that yes one more thing i used to take one penis size enlarge oil but very rarely might be because of that oil i am having this problem please suggest me best possible option to cure this ### Response: hi i can understand your concern as you are getting erections when you watch porn but are losing during sex this shows that problem is not organic the issues are more psychological confido helps to boost confidence but is not proper treatment for some times you can try tablet tadalafil or sildenafil either of these tablets if taken about half to one hour before sexual intercourse help to improve erection if problem persists then visit a doctor and get serum testosterone and prolactin levels done if levels of both these hormones come normal then remain relaxed no need to worry

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i will be facing major surgery for stage three lung cancer contained in the left lobe i am extremely allergic to fentanyl propofol and versed are there any alternatives to these anesthetics i am currently on synthroid ### Response: if you are allergic to these agents i suggest you undergo a detailed allergy test with various agents so that you will be able to know which agents are safer for you there are so many agents and techniques available nowadays in the field of anesthesia if you are allergic to propofol thiopentone sodium thiopental or etomidate is a safer option for analgesia the multimodal technique will be a safer option including regional anesthesia various blocks nsaids etc versed midazolam can be avoided at all during surgery so my suggestion to you is to inform your anesthetist about this and leave your worries on him

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have rheumatoid arthritis there is a long waiting list to see a rheumatologist in my place i am thinking of seeing a private doctor but i have limited funds how often would i need to see a rheumatologist i can not afford it every week or maybe every few months how often do you think i need a doctor visit i am hoping to be prescribed a dmard like methotrexate then when my slot comes up with the nhs i will go therei take naproxen which is not enough and i had a cortisone injection in my knee a couple of months ago the swelling did not go down completely but i walked better it has worn off now and i have pain in more joints and a feeling of lumps under my feet i am on a special diet and my crp esr and high rheumatoid factor have gone down by half but lately i feel unwell i would like to know the frequency of visits needed ### Response: i have gone through your history it is a bit unusual if you could throw some light on the history of arthritis it would be helpful if it was an intermittent one initially or now it has become persistent well as per the treatment if it is confirmed rheumatoid arthritis they will start you on methotrexate straight away the followup visits are usually within four to six weeks for the first time and then after three months but a lot depends on your treating rheumatologist most of them advise liver function tests after two weeks to see if the dose is not giving you side effects but that can usually be followed up with rheumatology nurse so once you are through with first visit and improvement comes then a three months visit suffices but if the disease keeps bouncing back then a bit more frequent visits are needed but hardly before six weeks as that much time it takes for any new dmard to act so it is a bit tough to predict but do not worry no rheumatologist will call you back in a week or two i hope this helps

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: due to the use of skinlite i have sunburn on my face and now it looks like the dark spot but i am using kojivit gel for a dark spot is kojivit gel good for the dark spot ### Response: hello you must use a broad spectrum sunscreen throughout the day reapply every to hours sun protection is important to treat facial pigmentation this cream should never be used without the supervision of a dermatologist as it can cause irritation redness and other side effects like acne use it only if your dermatologist says after looking at the skin condition i would request you to upload a picture so that i can assess the condition visually and therefore guide you better

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my son has a persistent headache since last days it started with headache consulted various neurologist got mri and ct done all clear he gave various medicines even noxdorm but no response ### Response: hello i understand your concern and would explain that his symptoms could be related to a tensiontype headache coming to this point i agree with the doctors prescription about citalopram and sibelium attachment removed to protect patient identity for this reason you should be patient if the situation does not improve in a couple of weeks i would recommend trying amitriptyline and valproate combination you should discuss with his doctor about these treatment options based on his test reports i would conclude about a primary headache benign related to psychological stress

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my wife and i had some argument about my past i had lied to her about the number of sex partners i had that hurts her because she explained that her perception of me was built on the fact that she knew that i only had a few sex partnerswe have been discussing this for months but now after having these discussions and arguments i realize that when we are to have sex i get anxious i will get an erection but when its time to enter it falls i want to know how to get my mind to a place of not over thinking so that i am not distracted kindly help ### Response: hello i am happy that you did understand that the problem behind your erection is the problem is related to stress and anxiety which is stemmed out of the differences between you and your partner that itself is the first step of the problem solver now the remedial measures are do not attempt to have sex when you have the thought and related stress in your mind start relaxation breathing for minutes at least once per day start physical exercise for one hour daily write down the cause and effect of the problem you are now facing with all the details then clear it logically alongside what you wrote you may have to write this for two weeks to get the desired result take care take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i feel a strange glitch in my vision it is quite big and takes up a large portion of my central vision it is neither a shadow nor a flash it looks like a greasy fingerprint smudge in my vision which disappears quickly it happens when i blink but mostly occurs when my eyes move quickly i have had it for the past few days and i do not know if it is anything to be concerned about please help ### Response: hi as per your description of symptoms it looks to be nonpathological it will occur when a thick eye secretion covers the cornea once you blink it will get clear this needs to be treated with artificial tear

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my tooth hurts anytime i eat or drink it feels hot i feel hot it is sharp pain that does not go away my gums are swollen ### Response: hello your tooth has sharp pain due to tooth sensitivity due to enamel erosion once you get it treated pain will subside if erosion has not involved the pulp then only restoration can help you or when the pulp is involved then root canal treatment will be a solution please share pictures and radiograph of your affected tooth tooth sensitivity iopar related to affected teeth restoration or rct of the affected tooth

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have had permanent cramps and a constant ache in both buttocks i have pain down the back of the legs in the calf and when i walk it feels like it is about to cramp and i get pain in front of the thigh i have a constant aching feel when i press my skin on both thighs it feels sore i had it for over two months i have pain on both sides of my thighs and legs regardless of if i am sitting or restingi got admitted to the hospital for two weeks and they did an mri scan on my spine and found nothing they did a lumbar puncture and found nothing they also did a nerve examination and nothing was found i am currently on gabapentin codeine and paracetamol ### Response: hi it looks like a nerve compression to me if all investigations are normal it does not mean it can not be nerve compression it could be meralgia paresthesia or neuralgia i would recommend you to take vitamin shots also discuss with your doctor to prescribe you a combination of pregabalin along with nortryptilline in the night this may take a few weeks to months to recover i hope this helps take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have small boils red and white on the head of my penis and also inside the skin and itching also i regularly clean with warm water and sometimes put some vaseline gel but nowadays it increases very much i think it is a fungal infection please suggest a good medicine and precautions to be taken to clear this infection asap this happened for the first time ### Response: hello from your history it appears to be a fungal infection could you please send me pictures for an appropriate diagnosis and treatment revert with more information to a dermatologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have observed a white smegma on my penis head there were irritation and red bumps on it before but i oiled it so now i do not have any pain or irritation but in the morning the white smegma is still there and my foreskin is hard and rough what should i do please help ### Response: if your foreskin is hard and rough you may get benefit from removing the foreskin ie circumcision i suggest you show it to the urologist nearby and get it done

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my put my mascara wand in his mouth his teeth and all around his mouth were black i used a toothbrush and water to get all the black out what else should i do i am not sure how much he swallowed can it harm him ### Response: hello mascara contains iron oxide carbon black along with a base of paraffin or mineral oil as your child had taken it in his mouth and you already have cleaned it now there is nothing to worry you may ask him to gargle with chlorhexidine mouthwash which will improve the oral hygeine if a very small amount was swallowed there is nothing to worry it may not cause any harm

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: last night and today i have been experiencing a sharp pain just left of the sternum which is not deep seemingly on top of the rib where it joins the sternum it lasts a second or two but may repeat several times before stopping in five minutes or so i went out in the garden today to dig a bit and wearing my hr monitor i have got health anxiety anxiety disorder as well as depression as i was digging the pain started hurting with each heartbeat i looked at my monitor and it read bpm i am years old and have been on medication benzodiazepines for over years for panic attacks and general anxiety two years ago i felt similar pain but not to this extent i went to er but nothing was found the doctor said it could be costochondritis but definitely not my heart i get bloodwork quarterly and everything was fine except cholesterol which was i tried a statin but the muscle pain was too great in my ekg i have rbbb or lafb which years back after a stress test i was told that i was probably born with it i had gone to see the cardiologist then because of getting skipped beats and gerd he told me to ignore them last time i had an ekg was in the er for six months when i had a weird pain in back and side they checked out heart anyway and said it was fine probably just a colicky gallbladder i have had stones for more than years and had no surgery so i hesitate to go to the er again my local doctor just closed hr is still while lying down right now usually my resting heart rate is under currently i am on lorazepam mg prevacid mg and baby aspirin ### Response: hello i have gone through your history and it does not appear to be an ischemic pain ischemic pain will not be sharp and so short lasting do you get an increase in pain on application of pressure at the same site if yes it supports the diagnosis of costochon take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am in my late month pregnancy recently i went for a scan named targeted imaging for fetal anomalies tiffa all the reports were normal except hypoplastic nasal bone and higher normal values of amniotic fluid i am approaching you for second consultation now my questions are what if we go for genetic amniocentesis and results were positive for downs syndrome can i terminate the pregnancy in my week of pregnancy how much safe it is to go for amniocentesis test is there any alternate test to get better results i decided not to have a baby who is mentally retarded please suggest me your valuable advice ### Response: i have thoroughly gone through your case and can well understand your genuine health concerns we can better comment on the outcome after getting the results of the amniocentesis you may terminate anytime depending on where you opt in for this termination i mean you need to have expert hands for amniocentesis is very widely done test all over the world and as for every diagnostic invasive procedure it has its own safety risk of complications is always there as it is associated with invasive procedure again i want to add that if you opt in for the expert hands and a seasoned professional obstetricians and gynecologists and interventional radiologist then there is no to low risk for the baby and the amniocentesis and karyotyping to rule out for genetic disorders that involve chromosomal anomalies is the best test universally no other choice as this is what we need to know next and this is the specific test available which may guide us about it is your right to decide and it is solely you who can decide about your body as to what is better for you physician can only guide you about the procedures and the final decision is solely your own as to what should be done

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my mother is years old she is suffering from head spinning and heaviness problem since the last six months her bp sugar thyroid and other blood test reports are normal after getting a suggestion from a doctor medicine she had gone on an mri test the mri test noncontrast of brain report was given with a doubt of evidence of blooming in gre in the left parietal lobe and right basifrontal lobe without evidence of perilesional edema and advised for further evaluation with contrast to rule out calcified granulomas and other etiologies also mri report findings includesmall vessel white matter ischemic changeschronic lacunar infarct in the right external capsulemild cerebral atrophic changesthe doctor of medicine gave medicines for the treatment of vertigo and nerve but suggested to show immediately to a neurologist my mother does not know the brain problem and she refuses to go to a doctor for further checking due to her fear so i need your help ### Response: i have gone through the detailed query and understand your concerns in my opinion there is a definite need for face to face consultation as it seems to me that there is a need for cognitive evaluation the mri changes observed are indicative of vascular pathology and should be treated if concomitant symptoms are present regarding the doubtful observation over mri nobody can help with this either one sees the mri report or you get contrast mri this will unearth the true pathology of blooming in the parietal and frontal lobes since there is no edema it can be concluded that there is little possibility of malignancy or recent changes but it does not rule out the chronic healed granuloma i request you to do following i hope this helps you thanks and regards for more information consult a neurologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have a small white scar on the lower lip for seven months it was not white at first but now it just stays there and does not show any change ### Response: your problem is nasolabial dyssebacia attachment removed to protect patient identity it is a type of eczema secondary to mild pityrosporum yeast infection associated with an oily part of the face with affected areas mild scaling and redness in few individuals you can start using cetaphil soap for face wash along with lulifin cream luliconazole once daily for days apply to the affected areas even if the skin becomes normal after days it flares with stress and over thinking nothing serious it is curable for more information consult a dermatologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am struggling to get up early in the morning i sleep for eight hours every day i press the snooze button many times but still i can not wake up early i became irregular to the work which became a barrier to my career currently i am taking tablet fluvoxin mg in the afternoon for ocd and depression tablet oxetol mg in the evening for gelastic seizure tablet quetiapine mg at night for delusions ### Response: you have to be strict about your schedule you are taking tablet quetiapine at night it is a standard medication which affects your sleep mostly due to oversedation but there is no other option if your delusions are under control with it or you may try another antipsychotic like risperidone you must sleep early at night if possible and take night medication soon at least at pm if you are going to sleep at pm fix your sleeping time from pm to am do not snooze alarm it is hard initially after that you will use to get up early if you have depressive features then treat your depression because depression can also cause a problem in sleep wake up issue for more information consult a psychiatrist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i had unprotected sex on of last month and missed my period on i did a urine pregnancy test on of this month it came negative and then i took regestrone mg for five days one tablet each day from to then on i did a bhcg which came negative and today i got a slight spotting and when wiping a little brownish kinda discharge came am i pregnant ### Response: no you are not pregnant as urine pregnancy test and hcg human chorionic gonadotropin test are negative you have taken regesterone so your period is delayed more your period should start now it normally takes two to seven days after the last regesterone tablet so do not worry you are not pregnant because it is already more than days after unprotected sex and all tests are negative brownish discharge can be the starting of menses you are definitely not pregnant do not take much stress

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i was running and i fell into a pit my ankle got twisted and i could feel some cracking sound i had a swollen ankle immediately i have been icing for days and now the swelling has reduced i am unable to walk i have pain when i try to move or walk i had a fracture fibula of the same ankle years back please help ### Response: as there is a history of twisting injury to your ankle with a kind of cracking sound or sensation which you have felt i will advise you to undergo an immediate xray of the affected part to rule out any bone injury xray ankle anteroposterior and lateral views getting an xray is all the more important as you have a prior history of fracture fibula of the same ankle you need to do the following till the xrays are done take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: the semen analysis report is in my hand but i can not understand itliquefaction time minutesduration of abstinence four daysappearance creamy whitevolume mlph presentmotility rapid slow nonprogressive motility immotile count millionmorphology normal abnormal ### Response: hello i read your query and understand your concerns about the semen analysis report as per the available semen analysis report you have very low sperm count and most of the available sperms are defective as you can see that almost of your sperms are defective and of no use in addition the count is just million per ml which is again very low considering this report there is a low chance of natural pregnancy to your partner as the sperms are low and available ones are defective i request you to see your doctor as you need treatment for improvement of the health of your sperms i hope this helps you

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i was seen in the er for a possible kidney stone i did have blood in my urine no stone was found the only thing noted on my ct scan reads urinary bladder wall thickening versus under what does this mean is this a sign of bladder cancer what followup is needed ### Response: i need to know some more details of the hematuria episode was bleeding associated with pain what was the location of pain was it radiating to the back or testes or penis were there clots shape and size if present past history do you have any reports like urine analysis done at that time revert with more information to a urologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a male i had genital warts five years ago had them removed via cauterization and received three injections of hpv vaccine gardasil the doctor said the vaccine would cure the virus but after a year warts reappeared and until now they are still in my scrotum and they are itchy but not painful my question is that can i have sex with my partner given my current condition have i got cured by hpv vaccine ### Response: hpv vaccine is not a cure it is for the prevention of hpv it prevents the virus from entering in your body but it can not act on cells which are already infected with the virus about sex there is a chance that with contact virus can spread to your partner if not already infected and being on scrotum the methods like condom will not help you would need to get treatment first for warts for more information consult an internal medicine physician online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a male years old weight is kg height is my penis is not getting hard for sex the penis is getting erect but not getting hard enough due to this i am not able to put my penis inside the vagina also i ejaculate within to seconds to stock and now i am avoiding sex because of this problem and getting less interest day by day i do smoke regularly and drink occasionally also i used to watch porn in excess and masturbate regularly please help me out i am very much tensed about my future sex life please consult me what to do i want to get rid of this major issue i can not tell this issue to my family or friends also i do not have enough money to consult a doctor privately please look into the matter ### Response: hi i have read your problems carefully after getting above mentioned history my assumption is that your problem is psychological rather than organic but i need some information and investigation reports to confirm it further if you want to visit any physician i advise to consult with endocrinologist first and after excluding organic disease you need a psychiatrist masturbation and doing sex are different issues in the case of masturbation we try to ejaculate as soon as possible but in case of doing sex we try to do sex as long as possible so there is a psychological issue besides this anxiety also can precipitate this problem so after doing some investigation and excluding organic cause i think you need some psychological counseling take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: one week ago i had intercourse on my third day of the period and after approximately hours of that i have taken an ipill from the next day of taking the pill i had severe back pain and lower abdomen pain which continues for one week and after one week i started bleeding and right now do not know why i am still bleeding is it my period that came again ### Response: i read your message can you tell me in detail about your periods date date of intercourse date of taking ipill and date on which bleeding started after ipill bleeding is expected for a few days but you said you got bleeding twice so please tell me all the dates so that i can conclude properly

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am seeking experts to comment on lowcarb dietswhat is the complete macronutrient breakdown for a typical lowcarb diet how much fat should you eat on a lowcarb diet how much protein should you eat on a lowcarb dietwe are looking for suggestions on vegan foods for energy name the foods you are recommending and set description as to why you are suggesting this food ### Response: i just read your query in general a person requires calories per day people should usually take around approximately grams of carbs daily but if someone is aimed at losing weight then they should aim for a low carbohy

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i think i am bipolar just a couple of weeks ago i felt and was told by my friends that i was more energetic and crazy than usual now i feel like there is no hope and nobody really cares but there is also that little bit of me that is telling me that i am faking this and that all i want is attention i just want to know what the heck is up with my head ### Response: hello it is a little early at your age to be diagnosed with bipolar illness sometimes that part of normal teenage hormones and puberty when it is mixed with some depressive symptoms basically if you are depressed you will feel irritable low feel like crying sad do not wish to eat have difficulty sleep there can be anxiety tiredness headaches etc in bipolar illness there will be a period of these depressive symptoms and then after a period of normalcy the reverse happens so if you have not had the manic or hypomanic phase then you probably suffered from major depressive disorder or generalized anxiety disorder

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am years of age i had unprotected sex and i am having sex with the same partner for more than a year and a half suddenly i got itching sensation and found that i have got itchy bumps on my penis which started clustering together later it healed automatically i also found when i run or walk a long distance and feel sweaty i feel the sensation and i get the bumps again these bumps are small and shiny at the tip and often get clustered and gets healed it does not give me a problem but i really feel demoralized and unfit i do not have these problems regularly also for a long time i have itchy inner thighs because of which my skin turned blackish white and is still itchy i am not sure whether i am infected please suggest me the solution to get diagnosed i can provide pictures if required ### Response: i have noted your concern and i have viewed the images attachment removed to protect patient identity you have genital molluscum contagiosum it is an std sexually transmitted disease they can be removed with electrocautery or radiofrequency cautery itchy rashes are due to fungal infection i suggest you apply candidb cream twice daily you may also take a tablet cetirizine mg once daily for symptomatic relief from itching regards for more information consult a venereologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: there is slight bleeding after anal sex i had a dropbydrop bleeding the next morning after passing stool ### Response: hello you have had mild trauma due to penetration in the anal sphincter which is causing bleeding you will need to follow few steps it will settle in a few days regards for more information consult an internal medicine physician online take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my year old daughter has stomach aches around the navel area that happens from time to time it lasts a few minutes each time and goes away abdominal xray and ultrasound were done and has not found any abnormalities or umbilical hernia stomach pain starts while eating or drinking and also at random times other symptoms including the passing of stools about four to five times a day including while having a meala most recent development within the last week has had several accidents and says she did not feel it coming this is not normal for her no other emotional distress could be a reason ### Response: i suspect three things it is just assumption based on history stomach ulcer as she had pain after food and water worm infection need to have a look after food if non of the above must be ruled out by investigations then it is called functional abdominal pain i advise you to visit a specialist she might require oneweek antibiotics and if symptoms not settled then endoscopy also but the best part is to visit the pediatrician so he can evaluate her in detail and examine her meanwhile you can give symptomatic treatment kindly consult your doctor to discuss the suggestion and take the treatment with consent

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am years old i got married month back i am bleeding after each sex it happened around four to five times also i get some pain and this is ignorable previously i suffered with period problem facial hair and pcos please help ### Response: you need to undergo a gynecological checkup especially a speculum examination to rule out any abnormalities of the cervix and vagina because of bleeding during sex if you are not planning for baby you can be on krimson oral contraceptive pills under gynecologist supervision or else you need to consult an infertility specialist and take medicines to regularize your cycles and ovulation reducing weight also will improve ovulation and periods i suggest you not to delay fertility in view of pcos

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my uncle is years old he got a myocardial infarction years back and another one before years he had four bypasses that year in the same year he was diagnosed with nyha he also had diastolic dysfunction aortic sclerosis and akinesia in lvnow he has shortness of breath swelling in the abdomen and feet wheezing and coughingis he now in stage d and what is his life expectancy after years of diagnosis of hf ### Response: this does not mean stage d this is likely stage c however he has to undergo echo for ejection fraction which would tell us regarding stage if despite all medical treatment he remains symptomatic and not able to do any activities then may be considered stage d such intermittent worsening of symptoms may occur in heart disease which gets settled with medicines you should get his medicine optimized his life expectancy also depends on ejection fraction i hope this helps

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: after shaving my face six days ago i saw a big red bump on the right side of my nose above the mustache at first i thought it might be a pimple last week i felt something wrong on my throat and visited a doctor doctor said lymph node inflammation and prescribed me penicillin doctor did not ask me anything about that red bump in my mustache area at that time i have been suffering from mild fever as well after my lymph inflammation right now i am worried again since the red bump on my mustache becomes large and from two or three openings drains watery liquid when i tried to squeeze it it is really painful and irritates a lot i am worried about hsv since it is near my mouth i am having mild fever and lymph infection i am not in sexual contact for the last seven years what is your suggestion what might cause this problem ### Response: two broad differential diagnoses are folliculitis or hsv herpes simplex virus infection most likely i would want you to know that we all are exposed to and it could spread without sexual contact it stays in the ganglion nerve endings and pops up when your immunity goes down it is also known as fever blister my feeling is that since you were about to come down with the sore throat which seems like strep throat you had a reactivation of the and got these lesions as you feel better they will subside you may use acyclovir if you want but usually we treat the underlying cause and you are receiving the antibiotics for sore throat please do not squeeze it you can use any antiinflammatory agent for pain and fever like acetaminophen you can also try topical steroids like desonide i hope this helps take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i recently tested positive for hiv and had a viral load test which was and count of my issue now is with how i could have contracted the virus i have had three sexual partners and there was always protection two tested negatives after i informed them about my results and the last and most recent is insisting he is not ready and it was protected all the way although we did have anal at times and i can not be sure that the condom was there i have also had a parasitic infection which affects my scalp for a couple of years is it possible for something to mimic hiv in tests i have been to the dentist thrice in all my life for an extraction and checkups i also had an appendicectomy years back i have had occasional iv therapy and a few injections i have never shown any symptoms i am also anemic ### Response: hi for condoms to be effective it has to be a latex condom used consistently and correctively and a newer condom for each sexual act there should not be any break or it should not have slipped off during the act if all the steps had been followed then only it is said that to effective in the prevention of sti and hiv unfortunately condoms are not used properly resulting in failure rates the tests which you underwent for hiv are highly sensitive and specific there is no chance of mimicking any other infection you need to initiate antiretroviral therapy as soon as possible it is a really effective therapy

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a year old female and i developed foot drop five weeks ago the foot was numb and i could not dorsiflex it but now i can dorsiflex and the steppage gait has disappeared unless i walk long distances i have more power in the foot now but it is still a lot weaker than the other one i can not walk on my heels yet however i have been extremely anxious about this foot drop and a couple of weeks ago i started to twitch first in the legs and then all over my body i can see the twitches when i am talking with someone and thinking about something else the twitches go away and come back when i think about it i do feel weak in my body especially in the legs can it be due to the anxiety i am going to a neurologist but there is a three months waiting period and i am scared i do not think we have had any als in my family please help me ease my mind ### Response: the twitches that you are feeling may be due to anxiety also if it was als amyotrophic lateral sclerosis the foot

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am years old and weighs about kg my whole body hurts i got pain all over the body pain in legs and hands pain is persistent all the time mostly in the lower feet and hand i am having pain for the past three months i just had an appointment with my doctor he ordered some blood work and told me everything is fine and he told me to see the rheumatologist once for my peace of mindi have attached my report do you see anything abnormal in my blood report what is the cause of my body pain is anything wrong with my body do i have any underlying conditions such as leukemia lymphoma or any other cancer do i have any liver disease or thyroid disease that can lead me to pain before three months i did a blood test and my rheumatoid factor was iuml and now it is iuml why it is going up with a short duration of time what do i need to doi am eating healthy and getting good sleep but i am not losing weight my vitamin d level is and i am taking vitamin i am taking vitamin d for almost one year i m taking iu for five days a week please explain in detail the treatment plan ### Response: hello well i have gone through your history and the reports attachedattachment removed to protect patient identity all the reports are normal i could not find the reports of liver function tests there but i suppose your doctor had already looked into it do not worry you dont have any cancers at the current time if any cancer would cause pain it surely would have affected your blood counts as well as for rheumatoid factor or can be lab variation or instrument variation but as long as you do not have joint swellings or pain it is insignificant my diagnosis for pain would go for fibromyalgia it is more of a diagnosis of exclusion and one only considers it after ruling out the other causes which they have done so far i will give you a link you can go through it and let me know if your symptoms match this as treatment will depend on your being convinced about the diagnosis i hope this helps fibromyalgia

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am worried about als i have had a twitch in my left hypothenar muscle intermittently for three weeks or so perhaps a few twitches per hour followed by hours of no twitching i also have twitches in other parts of my body quite regularly though this one is focal and the others are diffuse i have not dropped anything doing selftests my left pinky seems a bit weaker though i think i have atrophy in the hypothenar i have had three general practice doctors tell me it is just asymmetrical with my dominant right hand the doctors have also performed basic finger strength tests spread fingers and resist and they say they are normal reflexes are normal no tripping dropping slurring etc should i be worried about this given the above scenario and that doctors have told me no atrophy and no weakness thank you ### Response: i read carefully your question and would explain that your symptoms are not typical of als amyotrophic lateral sclerosis coming to this point i would recommend performing some tests to investigate possible causes consulting with a neurologist may be needed in case of abnormal emg for more information consult a neurologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am years old and have quit smoking years ago i still have a chronic cough each specialist tells me something different the pulmonologist told me it was asthma and another doctor said it was acid reflux disease now they are telling me it is copd i do not have diminished lung capacity or problem in breathing no wheezing out of breath when i run but i am overweight and out of shape what do you think ### Response: hello there is not much of difference between asthma and copd chronic obstructive pulmonary disease copd is usually seen in a person who has smoked a lot while asthma is seen from childhood which is not in your case acid reflux can cause prolonged duration cough but it shall subside very well once treated for acid reflux but in your case it has persisted so it has to be either copd or infection of the lung i would have favored copd if you were investigated for infection and found nothing hence i recommend specific tests for evaluating infection as the cause kindly get the following test done and revert with reports ct chest bal microscopy bronchoalveolar lavage and culture esr erythrocyte sedimentation rate montoux test i hope this information was useful for you any clarification feel free to ask